Do you have Fordyce Spots?

There are spots that occur on different places of the body, and cause a lot of stress when they are found under your belt.  I get a LOT of questions and pics sent to me with people very concerned that they have various Sexually Transmitted Infections (STIs), depending on what they have recently performed an internet search on. Some should cause some serious concern and some are benign.  Fordyce spots can occur inside your lips on your oral mucosa, or on the shaft of your penis, or on your labia.  I totally understand the freak out that it might be genital warts, or something else, so you should go get tested and assessed, but this is a little information to ease your worry before you get your results!

What are Fordyce Spots?

They are small, painless bumps that are 1cm to 3 cm in size and they can either be skin toned, white, or a little pink/red in color.  As I stated before, they are commonly found in on the inside of the lips, on the shaft of the penis or scrotum, and on the labia, and they are really a common occurrence, but occur more with age. Usually you only notice them when you see or feel them, but at times they can be a little itchy. They occur because the sebaceous glands, the oil glands associated with hair follicles normally that secrete sweat and oils, instead of being inside of the epidermal layer (deeper in the skin) are more superficial, and close to the outer layer of skin, making them very visible. These glands fill with oil, and there is no hair shaft for them to leave the skin, so they are basically little oil filled cysts. That’s it. They are not known to lead to a disease or are not a sign of cancer or any other virus/disease, but they just tend to be a visual disturbance for some people…and their partners.

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What can I do if I have them?

If you go to your Healthcare Provider (HCP), and get diagnosed with Fordyce Spots, they will give you some options for treatment, if it really is bugging you from a cosmetic standpoint, because they are not detrimental to your health in any way. And, they usually go away without treatment on their own. But healthy diets including Vitamin A, B, D, E, and K can usually help them from forming, and go away faster when you have them, so basically, if you get Fordyce spots, take a multivitamin daily and it can help to prevent them.  Good hygiene including exfoliation and moisturizer can help to decrease them from forming (so that your body doesn’t produce excess oil; this works on both the lips and the genitals), and there are some reports that people with either eat more garlic or take garlic supplements have a lower rate of the spots.  Your HCP may prescribe Trentinoin cream, which is a cream that can basically makes the cells replenish faster, so you ave never skin cells forming, which can prevent the skin from getting clogged up with oils. But, again, the only treatment you may need is time.

All of this being said, you do need to get checked out by your HCP if you do have any new skin issues, especially in your genitals, and you are sexually active, you really need to make sure that it is something benign and not Human Papilloma Virus (HPV) in the form of genital warts, herpes, or any other Sexually Transmitted Infection (STI). Get yourself checked out to be on the safe side, but also realize that every bump isn’t contagious or infectious!

Yours in Good Health


What is the most contagious STD?

I was quite shocked that crabs (AKA pubic lice) is as prevalent as it is. But in the past week I have been asked about it three different times from people all over the US, which made me think that this topic needed a little discussion related to what crabs are, how you get them, and how to treat them.  I wasn’t sure how prevalent they are, but they are clearly around, and infections are on the rise.

What are crabs?

Crabs are also known as pubic lice (Pthrius pubis) and they are parasitic insects that feast off the blood of humans and live in coarse hair (i.e. pubic hair, eyebrows, eyelashes, chest hair, armpits, mustaches, & beards) causing itching, discomfort, and rashes. So you can understand how they can not only be really irritating, awkward, and kind of gross to think about, right?  They pass from person to person usually through sexual intercourse (or sexual acts) but they can also jump from person to person through hugging or other close contact (sharing towels, clothes, bedding, etc.) Despite the fact that crabs can’t live very long away from the warmth of a human body, they are still the most contagious STD, and if an infected person has sex with a non-infected person, the risk of getting crabs is about 90% for that previously non-infected person.  That is pretty shocking, and horrifying…a 90% chance?!?  Plus the lice live from about 1 to 3 months, and in that “lifetime” the average female lice has about 300 eggs, which means they breed quickly and frequently! These parasites spread quickly.

What are the signs and symptoms of infection?

Usually the only symptom is itching….extreme itching.  Sometimes you can visualize the bite marks on your skin, they are bluish in color, due to the bruising from them sucking your blood to the surface, but it is very hard to see. Sometimes there are little red bumps from the bites, and then scratching them. Most often the itching and discomfort brings people in to their HCP.

How do I treat it?

First, when you find out that you are infected, let the people you live with and sexual partners know about the crabs, and clean all sheets, clothing, towels, etc in water that is at least 130F and dry it thoroughly in a dryer to kill off the lice living in the sheets.  If some of these items cannot be washed, then have them dry cleaned.  You can also buy an over the counter (OTC) treatment from your local pharmacy, like Permethrin 1% creme, that you apply to the affected areas (not near eyes), leave on for 10 minutes, then wash out and with a fine toothed comb, comb through the hair to remove all eggs and dead lice.  Usually this one time treatment works, but you MUST see an HCP to get treatment if the OTC doesn’t work, if you are pregnant, children under 2 years old, or teens under 18.  There are some treatments that are prescription only, so you need to see your HCP and get diagnosed. One other option, after you treat the area, is to shave off all affected areas (this is a little radical and not usually suggested by most HCPs) but if there is no hair to cling onto, there will be no pubic lice….just make sure to kill off the current infestation you have. Makes sense right?

Can I prevent it?

Well, you can ask partners if they have crabs, which I would hope they would abstain from sexual contact if they knew they had crabs, but its worth an ask.  Unfortunately, condoms do not prevent the spread of crabs, which is a total bummer.  If you have previously been infected (or are infected currently), make sure to wash or dry clean everything (as stated above, use the OTC treatment, and if symptoms are not cleared up, go see your HCP for further treatment, and bleach your bathroom/anything you use on your hair/body hair for grooming.

So unfortunately, it is highly contagious and can be an awkward treatment, but limiting your sexual partners, and asking about STD’s is a start at prevention.  Also, use your intuition: if you see someone scratching their crotch or just all over when you’re out with them, ask them if they have some sort of skin issue or lice.  If they say they are just super itchy and they don’t know why?  Steer clear!!

Yours in Good Health


Is BV an STD?

Bacterial Vaginosis, more commonly referred to as BV, is the most common vaginal infection in women, and despite the fact that you can get it after having sex with a new partner, it is NOT a sexually transmitted disease; your new partner doesn’t infect you.  I can’t tell you how many times women have gone screeching into their GYN’s office freaking out that they got an STD because something smells funky down there (which is a good practice to have, btw) but BV isn’t an STD and you don’t need to trash your new partner all over town about it!  Here is an explanation of what it is, symptoms, diagnosis, and treatment options.  I want you all to be aware of what could be going on down there… especially since it is National BV Awareness Day!!

BV_Day_Campaign_Pic.jpg.pagespeed.ic.rGAMMGEpleWhat is BV?
Basically it is an overgrowth of one of the natural occurring bacteria in your vagina, and when the delicate balance that is your vagina gets an overgrowth of one bacteria, there can be foul smelling discharge, itchiness, odor, pain, and/or burning.  Most commonly it smells like a dead fish down there….not good, ladies.  And, if it takes someone saying something to you about it, even worse.  Pay attention to what’s going on in your vagina, and notice if something smells off or looks funky.

So, How do I get BV?
Well, unfortunately, it is not completely known why some people are more prone to these infections than others. But, new sexual partners and having multiple sexual partners can cause a BV infection; it may be due to the use of numerous condoms and your body is reacting, or due to the change in your natural flora from having everything disrupted frequently down there.  Some women know that after they have sex with a new person, they will get BV, so they preemptively have a plan with their HCP about it (which is some smart thinking!)  If you have unprotected sex, it can just be that mixing their bacteria with yours causes an upset, and your body reacts the way it knows how and can.  Also, women who douche tend to have a higher frequency of BV; although this is a little bit of the chicken/egg debate. Women who douche tend to think that their vagina smells, and they may already have an overgrowth of bacteria just because they do, so they douche, and flush that bacteria all over the place, and cause an even bigger disruption in their flora, causing a more widespread BV, so they link the douche to BV, whereas they probably had the infection anyway. Oh, and women who are NOT sexually active can get BV infections; some peoples vaginal floras are just more sensitive than others.  It is a bit of a medical quandary though….

What are the signs/symptoms?
Strong fishy odor, that increases after sex
White/gray thin discharge
Itchiness around the outside of the vagina
Stinging/burning with peeing
OR no symptoms at all!

How can BV affect me?
Having a BV infection can increase your risk of contracting HIV if you are exposed to the virus
It also increases the risk that you will pass along HIV to a partner (if you are infected)
Having BV (past infections) increases your post operative risk for infection (post hysterectomy, abortion, or other gynecological surgeries)
Having BV increases your risk of also contracting HSV (Herpes simplex virus), Chlamydia, and Gonorrhea (your vaginas natural defense mechanisms are down due to the BV infection)
A BV infection while pregnant can increase your rate of complications such as pre-term labor, lead to low birthweight babies (under 5.5lbs), and premature babies.
Also, undiagnosed BV can lead to PID (Pelvic Inflammatory Disease) and make getting pregnant a very difficult task.

Are there any tests to determine BV?
The main “test” of determining BV is based upon your complaints (i.e. grey discharge, smelly odor, etc) and with a pelvic exam and taking a small sample of discharge from your cervix and examining a smear by your HCP. Balance Activ has just created an OTC pH testing kit, so if you suspect BV, you can use a testing strip and actually diagnose your BV. There are no blood tests or anything fancy to diagnose the infection, but seeing as it is so common, if an HCP even suspects it, without you complaining of symptoms, they may treat you anyway.

Is there a treatment available?
Honestly, many times it will clear up without treatment on its own, as long as you abstain from sex and using douche; the vaginas natural flora will fight to get back to normal BUT due to possible complications that can occur with long term infections, most likely you should get treatment if it is suspected.  There is a company called Balance Activ, that has a full line of products to help normalize the pH balance of the vagina, which will essentially treat and prevent these infections. Also, of note, male sexual partners do not need to be treated, but women partners do to prevent to possible spread!  There are two different antibiotics used to treat BV (you only need one): metronidazole or clindamycin orally (and the same treatment is for HIV+/-).  All pregnant women with any signs should be treated, and most HCP’s require that all women post gynecological surgeries be preemptively treated.

How do I prevent BV infections?
The best way is to limit your sexual partners and don’t douche!  Honestly, I am not sure why douche is still on the market, there is nothing good that comes from douching….so please don’t! Douche changes the pH of your natural flora, and the lower the pH is, the higher the risk of BV infections. Also, if given antibiotics as treatment, use all of the medication given to you to treat your BV, for the ENTIRE prescription, so that you actually kill off the bacteria and allow for your flora to re-grow.

The Balance Activ products that can help to treat and prevent infections are: Fresh wipes (neutral pH), fertility gels and sprays (to help normalize the pH levels, prevent BV, and allow for a better chance of conception for those with BV), and screening kits so you can test your own pH levels to see if you have BV.

It is important to note that BV infections can come back, and some people think that using probiotics can help encourage the regrowth of the natural bacteria and get it to normalize, there is no literature to support that, but if you are a chronic BV’er, it might be worth a try.  And, all of the Balance Activ products are a BOGOF (buy one get one free) in honor of national BV awareness week) so they are worth more than a try! If you do get BV infections after sex, talk to your HCP about different things to might try, like different kinds of condoms (you may have a small allergy), if you are in a monogamous relationship an don’t use protection maybe you need to clean your partners penis with antibacterial soap and you shower before intercourse. This doesn’t have to be a horrible life affliction, but to those who don’t know about it, you need to be aware and get proper treatment because it can have longterm health effects!

To learn more about BV, and products available, please check out this site directed towards BV awareness and treatment!

Yours in Good Health